Fatty liver disease has quietly become one of the most common conditions in the United States, and researchers keep hunting for tools that could slow it down.
A review published in July 2026 in the Journal of Herbal Medicine points to an unexpected candidate. Non-psychoactive cannabis compounds may influence the liver by first changing what happens in the gut.
The review, led by Jeyakumar Balakrishnan and colleagues, examined how four phytocannabinoids, meaning plant compounds from cannabis, appear to act on the gut microbiome and the gut-liver axis.
The compounds studied were CBD (cannabidiol), THC (tetrahydrocannabinol), THCV (tetrahydrocannabivarin) and CBG (cannabigerol). This was a review of existing mechanistic evidence, not a clinical trial in patients.
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Why the liver is on the radar
Metabolic dysfunction-associated steatotic liver disease, or MASLD, is the new name for what most people still call nonalcoholic fatty liver disease.
It is a buildup of fat in the liver in people who drink little or no alcohol.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, about 24 percent of American adults have NAFLD, and 1.5 to 6.5 percent have the more damaging form known as NASH, or MASH.
The condition often causes no symptoms at all.
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When it progresses, the Cleveland Clinic lists warning signs including an ache in the upper right abdomen, extreme fatigue, loss of appetite, unexpected weight loss and a yellowing of the skin and eyes.
Obesity, type 2 diabetes, insulin resistance (when the body's cells respond less effectively to insulin) and abnormal blood lipids are the main drivers.
What the review actually found
The Indian research team focused on a single pathway. Signals travel constantly between the gut and the liver through the portal vein and bile ducts, and the makeup of the gut microbiome can push those signals in a healthier or a more inflammatory direction.
In the animal and cell studies pulled together by the reviewers, CBD, THC, THCV and CBG shifted the microbiome in ways associated with better liver outcomes.
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Beneficial bacteria such as Akkermansia and Lactobacillus became more abundant, short-chain fatty acid producers increased, and the intestinal barrier and bile acid signaling appeared to improve.
Each compound worked through a distinct set of receptors, which is why the authors argue they should not be treated as interchangeable.
The reviewers stress that larger randomized, controlled trials in humans are needed before any clinical recommendation can follow.
What this means for CBD users
None of this is a green light to self-treat a fatty liver with a CBD gummy. The 2026 paper are mechanistic, not clinical.
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They point to plausible biology in animals and cells and leave the harder question, whether over-the-counter CBD products change disease outcomes in people, still open.
The most established advice for slowing or reversing MASLD remains weight loss, treating diabetes and high cholesterol, and cutting alcohol.
Anyone with elevated liver enzymes or a diagnosis of fatty liver disease should discuss supplements, including CBD, with their doctor, because cannabinoids can interact with common medications.
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This article is made and published by Ida-Marie Palm Varbæk, who may have used AI in the preparation.